Adaptation to early knee osteoarthritis: The role of risk, resilience, and disease severity on pain and physical functioning

Background Radiographic joint changes are used to diagnose osteoarthritis; however, they alone do not adequately predict who experiences symptoms. Purpose To examine psychological risk and resilience factors in combination with an objective indicator of disease severity (knee X-rays) to determine what factors best account for pain and physical functioning in an early knee osteoarthritis (KOA) population. Methods Structural equation modeling was used to analyze data from 275 men and women with early KOA. Results Structural equation modeling yielded a fair to good fit of the data, suggesting that both risk and resilience were important in predicting pain and physical functioning over and above disease severity in the expected directions. Resilience's effect on pain was mediated through self-efficacy, suggesting that higher self-efficacy was linked to lower pain and better physical functioning. Conclusions Results provide an integrative model of adjustment to early KOA and may be important to the prevention of disability in this population.